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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 3

Category: Medical/Surgical/Diseases/Complications

Poster Session 3

(708) Severe maternal morbidity in pregnancy among individuals with connective tissue disorders: a national cohort study

Thursday, February 12, 2026
10:30 AM - 12:00 PM  
Objective:
Connective tissue disorders (CTDs) are characterized by systemic inflammation that increases risk for pregnancy complications, including preeclampsia, thromboembolism, and renal dysfunction. Given these known risks, we evaluated whether CTDs are associated with increased likelihood of severe maternal morbidity (SMM) during pregnancy and postpartum using a large real-world electronic health record database.

Study Design:
We conducted a retrospective analysis using TriNetX, a research platform of de-identified electronic health records from over 155 million patients across 109 health systems. We identified pregnant individuals aged 12–55 years through July 2025 and categorized them based on presence or absence of CTD within the year prior to pregnancy, including antiphospholipid syndrome, rheumatoid arthritis, Sjögren’s syndrome, systemic lupus erythematosus, and scleroderma. Propensity score matching balanced cohorts by age, race, ethnicity, obesity, asthma, hypertension, and hyperlipidemia. SMM was defined using the CDC’s 21 indicators and ICD codes. We assessed odds of composite SMM and each individual condition occurring within one year of pregnancy onset.

Results:
After matching, 37,365 individuals with CTD and an equal number of controls were analyzed (Table 1). Those with CTD had significantly higher odds of experiencing composite SMM (4.9% vs 2.0%, OR 2.8, 95% CI 2.8-3.4, p< 0.001). Nearly 2% of individuals with CTD experienced disseminated intravascular coagulation (DIC; OR 6.7, 95% CI 5.4-8.2; Table 2).  Additional indicators with elevated risk included thromboembolic events -- cerebrovascular complications (OR 4.5, 95% CI 3.4-6.0) and venous thromboembolism (OR 5.7, 95% CI 4.2-7.7).

Conclusion:
Pregnant individuals with connective tissue disorders face significantly increased odds of SMM, with DIC and thromboembolism most strongly associated. This likely reflects immune-mediated endothelial injury and proinflammatory cytokine activation. These findings underscore the need for risk stratification and multidisciplinary management to mitigate maternal risks.